Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition characterized by persistent patterns of inattention and/or hyperactivity-impulsivity that interfere with functioning or development. For individuals serving in the Armed Forces, a diagnosis of ADHD after joining shifts the focus from initial screening to retention and fitness for duty. When the diagnosis occurs while in service, the military determines the extent of functional impairment and whether the service member can maintain the performance standards required by their job and the overall force. This process involves a structured medical review to assess the condition’s stability and its impact on the individual’s ability to deploy and perform all required military duties.
The Initial Medical Review and Profile Status
Following an in-service diagnosis of ADHD, the service member is immediately referred to Behavioral Health services for a comprehensive evaluation, working closely with their Primary Care Manager (PCM) in the Military Treatment Facility (MTF). This involves the generation of a medical profile, utilizing the Physical Profile Serial System, known as PULHES. PULHES assigns a numerical rating from one to four across six physical and mental categories, with the “S” category representing psychiatric conditions. A rating of “1” indicates normal function, while a “3” or “4” signifies a significant medical condition requiring duty limitations.
The medical profile documents specific functional limitations, such as those related to concentration, impulse control, or the need for consistent medication. A higher numerical designator in the “S” factor often results in a temporary or permanent administrative limitation on duties. For instance, a profile may restrict the service member from carrying a weapon, performing duties in isolated environments, or deploying overseas while the diagnosis is being evaluated and treated. This profile status communicates the service member’s current medical restrictions to their commander, ensuring they are not assigned tasks compromised by the condition.
Retention Criteria and Service Limitations
The decision to retain a service member with a post-accession ADHD diagnosis depends heavily on the condition’s stability and the absence of significant functional impairment. Military retention standards focus on the ability to perform all duties required of their rank and specialty, including worldwide deployability. The condition must be well-controlled, and the service member must demonstrate the capacity to function effectively without requiring frequent, specialized accommodations. Symptoms must be managed so they do not interfere with safety, mission readiness, or the maintenance of security clearances.
A common requirement for retention is stability on the treatment plan, often without changes to medication or significant behavioral health intervention, for a defined period, typically 12 months. Failure to demonstrate consistent, stable performance or the presence of co-occurring mental health disorders can be grounds for separation. Furthermore, certain specialized career fields have zero-tolerance policies for conditions affecting cognitive function or impulse control, potentially leading to immediate removal from duties like flight operations or Special Forces. The persistent inability to meet physical or mental standards determines if the service member can continue their career.
Military Treatment and Medication Management
If the service member is retained, ADHD treatment is managed through the military healthcare system, involving specific protocols, particularly regarding medication. Stimulant medications are psychoactive substances tightly controlled within the military environment. The use of these medications requires rigorous monitoring by military medical providers to ensure symptom control and adherence to safety regulations.
The ability to deploy without interruption is a major consideration; medication must be stable and effective without causing side effects that impair performance in an operational setting. While the diagnosis alone may not be disqualifying, reliance on medication can sometimes present a barrier to retention or deployment. The service member must demonstrate that their treated condition does not compromise their ability to perform combat or deployment-related duties.
Medical Separation Procedures and Disability Implications
If the service member’s ADHD is determined to be unstable, unmanageable, or significantly impairs their ability to perform duties, they will be referred into the formal disability evaluation process. This process begins with the Medical Evaluation Board (MEB), which reviews medical evidence to determine if the condition meets retention standards. If the MEB concludes the service member does not meet these standards, the case is forwarded to the Physical Evaluation Board (PEB).
The PEB makes the final determination of “fitness for duty,” deciding whether the service member should be returned to duty, medically separated, or medically retired. If the PEB finds the service member unfit, it determines if the condition is “service-connected,” meaning it was incurred in or aggravated by military service. This distinction is crucial, as a finding of unfitness leads to either medical separation with severance pay or medical retirement with lifelong benefits, depending on the assigned disability rating. The PEB uses the Veterans Affairs Schedule for Rating Disabilities (VASRD) to assign a percentage rating, which directly influences the level of Department of Defense (DoD) disability compensation and eligibility for future Veterans Affairs (VA) disability benefits.